The Problem With Perfection

There's a thin line between wanting to look pretty and becoming obsessed with perfection.

My nostrils look like bat caves. Another age spot? Why are my lips so crooked?

Staring into my iPhone, I've gone from smiling to pouting to looking pensively at the camera, all to get the perfect pic for my LinkedIn profile. (I've been at this for about half an hour now.) Somewhere around the 24th shot — which, of course, I hate — I realize it's not a lighting issue or the wrong lip gloss. It's me: I'm more self-conscious and critical than ever. I don't think I was always like this.

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Once, only celebrities battled constant scrutiny. But now everyone has a public image — whether it's Facebook, Instagram, Twitter, or the most superficial of all, Tinder — and it's being viewed on a daily, sometimes hourly, basis. We've never had to look at ourselves (or one another) so much. And for some women, it creates a compulsive obsession with looking perfect ... the feeling like something's always a little off. Call it beauty dysmorphia.

Much like body dysmorphic disorder, a mental condition that afflicts about 2 percent of the population and makes them fixate on a perceived physical flaw that doesn't exist, beauty dysmorphia causes a warped sense of self-image. And while it may not be a clinical diagnosis, coveting extra-pillowy lips, crease-free skin, a perfect nose, or killer cleavage (the list goes on) can cause some women to display one very real body-dysmorphic tendency: an obsession with cosmetic tweaking. And it's easier than ever to indulge in.

If You Don't Like It, Fix It"Cosmetic surgery is no longer the domain of ladies who lunch, or the rich and famous — true just a decade or so ago," says Vivian Diller, Ph.D., a psychotherapist in NYC who specializes in women's issues. Affordable, accessible treatments may sound like progress, but they can be a slippery slope.

The biggest game-changer of all: wrinkle-reducing injectables. Initially, a treatment to smooth a few unwanted furrows, "they're now the go-to for avoiding wrinkles altogether," says Ellen Marmur, M.D., a dermatologist in Manhattan and associate clinical professor at The Mount Sinai Medical Center. The widely accepted practice of smoothing expression lines before they even form or plumping skin before it slackens seems like common sense, not to mention a smart investment, to many 20somethings. So much so that in the last three years, Botox has spiked 30 percent among the set (with volumizing injectables like Restylane and Juvederm also gaining popularity). It's not a bad thing to want to preserve your skin, but this practice can easily change the mindset of women (particularly those with beauty-dysmorphic tendencies) who now — with a doctor's approval — see problems before they even exist.

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"Having a wrinkle smoothed or even your lips plumped is usually the gateway to more cosmetic treatments," says Jessica Wu, M.D., a dermatologist in Los Angeles with a celebrity clientele. "Once they become comfortable with a needle, they start to consider more invasive surgeries like cheek implants, lip lifts, and breast augmentation."

The Social FactorPutting your image online, especially if you've spent time or money perfecting it, presents a whole new set of problems. Considering how I felt taking (and retaking) my LinkedIn profile picture, I can see how the cycle starts. I'd never scrutinized my image so hard ... or for so long.

"Social media has made us more conscious of our natural flaws," says Diller. After all, how many times have you seen a girl out with friends lunging for a phone, demanding approval rights before a pic is posted? And ever since Instagram hit the scene — with its skin-perfecting filters — reality seems a bit tougher to take.

It's also easier to see how you stack up against everyone else, an issue health experts have identified as compare-and-despair syndrome, which is driving a more extreme plastic-surgery trend. A recent poll by the American Academy of Facial Plastic and Reconstructive Surgery found that doctors are seeing a 31 percent increase in cosmetic requests from people who say they want to look better online.

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Cue the Facebook Facelift. What sounds like a Joan Rivers–style overhaul for the 60-plus crowd is actually a series of smaller procedures — chin augmentations, nose jobs, lipo — done by the selfie generation with the end goal of looking hotter in social-media pics.

Pack MentalityOne of the more disturbing aspects of this mindset: It can be contagious. Think about it. If everyone in your circle has her frown lines ironed out and her lips plumped like bike tires, you might start to view these treatments as simply things you do, like plucking your eyebrows or highlighting your hair. Your beauty standards may shift so that duck lips and a frozen forehead are what pretty looks like to you, and you become willing to go under the needle to fit in. Our friends have influence over what we think is normal, and that extends to the spa and derm's office.

"I have many groups of super-close friends and sisters who schedule their appointments together," says Dr. Marmur. She adds that when it comes to treatments, certain pals are enablers who lead the way. "It's a healthy thing to do if the lead friend is typically a good judge." But if she displays dysmorphic tendencies? It can become a situation of the blind leading the blind. Before you know it, a group of friends starts resembling the Real Housewives.

Reality CheckIt's human to look in the mirror and see room for improvement. But how do you know when your thoughts (and behaviors) cross into dysmorphic territory? Diller has a handy three-point checklist: when your view of beauty becomes too rigid (e.g., you're trying to look exactly like Miranda Kerr or Adriana Lima); when the voice in your head is constantly critical; and when your appearance becomes top priority. If this sounds like you, there are therapists who specialize in image issues.

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Here's how I handle the pressure to be perfect: When I find myself scrutinizing an age spot like a Rorschach test or counting my pores, I take two steps back from the mirror. It's a much nicer view.

This article was originally published as "How Do You See Yourself?" in the May 2014 issue of Cosmopolitan. Click here to get the issue in the iTunes store!

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